There is no abstract available for this dissertation.

Project report (D. Min.)--George W. Truett Theological Seminary, Baylor University, 2006. / Includes bibliographical references (leaves 95-99).

Thesis (Ph. D.)--University of Washington, 1999. / Vita. Includes bibliographical references (leaves 169-188).

Thesis (M.A.)--Brigham Young University. Dept. of History. / Includes bibliographical references (leaves 125-129).

Thesis (Th. M.)--Grace Theological Seminary, 1992. / Includes bibliographical references (leaves 101-120).

Thesis (M.A.)--Brigham Young University. Dept. of History. / Electronic thesis. Includes bibliographical references (leaves 125-129). Also available in print ed.

Thesis (Th. M.)--Grace Theological Seminary, 1992. / Includes bibliographical references (leaves 101-120).

Background: Type 2 diabetes mellitus (T2DM) is a major health concern among Navajo Indians. Native Americans and Alaskan Natives (NA/AN) currently have the highest rates of T2DM in the United States (Indian Health Service, 2016). The rate of diabetes on the Navajo Indian reservation is 22% (Partnersinhealth.org, 2009). Major health concerns for patients with T2DM include cardiovascular complications. Treatment is essential to prevent high-risk complications such as, cardiovascular disease (CVD). Purpose: The purpose of this quality improvement project was to implement a clinical decision support tool (CDST) to increase primary care provider awareness of current American Diabetes Association (ADA) statin therapy guidelines. The first objective was to increase the prescription rates of statin medications by 10%. The second objective of this project was to increase the performance target rate by 10%. Setting: This project was implemented at the Gallup Indian Medical Center (GIMC) Family Medicine Clinic. GIMC is located in Gallup, New Mexico. Participants: Participants included primary care providers, six Medical Doctors, two Nurse Practitioners, and one Physician Assistant. Methods: An evidence based clinical support decision tool (CDST) was generated the ADA statin therapy guidelines. Participants were educated on these practice guidelines and the CDST. The CDST was implemented into the electronic health record (EHR) over a four-week period. The provider used the CDST as a point-of-care guide when prescribing statin therapy to those with T2DM. Results: There was a 0.5% increase in the GPRA performance rating at GIMC as well as a 10% increase in prescribed statin therapy medications. There were 253 newly prescribed statin medications during data collection. Conclusion: While this project did not result in significant improvement of statin therapy GPRA performance ratings, a new EHR tool that providers can use to improve patient care was implemented. One outcome was met, there was a 10% increase in statin medication prescriptions. Further studies and future PDSA cycles will be required for testing the effectiveness of CDSTs.

No description available.

Coal-fueled energy development in the Southwest has resulted in a controversy over claims of environmental damage and spiritual and social disruption to the Native American inhabitants of the region. Development has been supported through estimates of the economic benefits that will accrue to the Hopi and Navajo through the planned development. This research has developed a modeling approach to systematically and rationally assess the impacts of energy development on the Hopi and Navajo Tribes. The model incorporates a simulation technique that describes the Indian social systems over time with and without energy development. The variations within the system without energy development and with various levels of development allow insights into impacts. Computer control allows the model to consider many different decisions relative to energy development, and incorporated graphics allow for efficient and fast impact interpretation. The results of the model indicate that proposed impacts on the Native Americans have been exaggerated. Neither the economic impacts nor spiritual disruptions claimed are seen to occur. The model is seen to be a valuable tool for systematic analysis and the presentation of social impact information.